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ESBL-producing E. coli identified in US communities

Issue: October 2012

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SAN FRANCISCO — Highly drug-resistant Escherichia coli infections that produce extended-spectrum beta-lactamase appear to be occurring in healthy individuals in communities throughout the United states, researchers suggest.

Presenting at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Yohei Doi, MD, PhD, assistant professor at the University of Pittsburgh Medical Center, said the spread of this infection is concerning because there are limited antibiotic treatment options.

Doi and colleagues studied the occurrence, risk factors and clinical outcome of community-acquired E. coli infections producing extended-spectrum beta-lactamase (ESBL). They investigated patients with the disease at five hospitals and their affiliated clinics from 2009 to 2010. The researchers screened the patients for global epidemic sequence type (ST) 131.

A total of 291 patients were identified, of whom 107 had community-acquired infection, as they had no health care-associated risk factors such as recent hospitalization. Of these infections, 54% were found to be caused by the ST131 strain. All of the infections were resistant to penicillins and cephalosporins. Also, 88.5% were resistant to ciprofloxacin and 68.3% were resistant to trimethoprim-sulfamethoxazole.

Several independent risk factors were identified, including cardiovascular disease (OR=3.0; 95% CI, 1.1-7.9), chronic renal failure (OR=5.6; 95% CI, 1.4-21.8), dementia (OR=18.3; 95% CI, 2.2-154.2), solid organ malignancy (OR=8.8; 95% CI, 1.8-43.3) and hospitalization within the previous 12 months (OR=12.8; 95% CI, 6.6-24.7).

For more information:

Doi Y. #C2-112. Presented at: 52nd ICAAC; Sept. 9-12, 2012; San Francisco.

Disclosure: The researchers report financial relationships with Achaogen , Astellas, AstraZeneca, Bayer/Trius, bioMerieux, Forest, Johnson & Johnson, Leo Pharmaceuticals, Merck, Novartis, Pfizer and Sanofi-Pasteur.